Ultrasonic forceps

ABSTRACT

An ultrasonic forceps comprises a housing, an acoustic assembly, and a tine. The housing joins the acoustic assembly and the tine to the forceps and permits the tine to pivot relative to the acoustic assembly. The acoustic assembly comprises a transducer, a waveguide, and ultrasonic blade, and a waveguide sheath. The transducer is configured to generate ultrasonic vibrations directing the ultrasonic vibrations to the waveguide. The waveguide communicates the ultrasonic vibrations distally to the ultrasonic blade. The ultrasonic blade is configured to vibrate in response to the ultrasonic vibrations generated by the transducer. When the tine is pivoted relative to the transducer, the tine is configured to move toward the ultrasonic blade. Tissue may be grasped between the tine and the ultrasonic blade. The tissue may be denatured when the ultrasonic vibrations generated by the transducer vibrate the ultrasonic blade, thus resulting in the tissue being cut and/or sealed.

BACKGROUND

A variety of surgical instruments such as shears incorporate the use ofultrasonic elements to vibrate at ultrasonic frequencies to cut and/orseal tissue (e.g., by denaturing proteins in tissue cells). Thesesurgical instruments include piezoelectric elements that convertelectrical power into ultrasonic vibrations, which are communicatedalong an acoustic waveguide to a blade element. The precision of cuttingand coagulation may be controlled by the surgeon's technique andadjusting the power level, blade edge, tissue traction and bladepressure. A variety of forceps instruments incorporate the use of radiofrequency (RF) energy to cut and/or seal tissue. Such forceps may beused in surgical procedures requiring fine or precise surgicaltechniques. In particular, two tines of a forceps instrument may be usedto precisely grasp tissue. RF energy (e.g., electrical current appliedat a frequency within radio frequency ranges) may then be applied to asingle tine (mono-polar) or both tines (bi-polar) to cut and/or sealtissue. Examples of forceps instruments that incorporate anultrasonically vibrating feature are disclosed in U.S. Pub. No.2009/0036912, entitled “Ultrasonic Surgical Instruments,” published Feb.5, 2009, the disclosure of which is incorporated by reference herein.

Other examples of ultrasonic surgical instruments include the HARMONICACE® Ultrasonic Shears, the HARMONIC WAVE® Ultrasonic Shears, theHARMONIC FOCUS® Ultrasonic Shears, and the HARMONIC SYNERGY® UltrasonicBlades, all by Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio. Furtherexamples of such devices and related concepts are disclosed in U.S. Pat.No. 5,322,055, entitled “Clamp Coagulator/Cutting System for UltrasonicSurgical Instruments,” issued Jun. 21, 1994, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 5,873,873, entitled“Ultrasonic Clamp Coagulator Apparatus Having Improved Clamp Mechanism,”issued Feb. 23, 1999, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 5,980,510, entitled “Ultrasonic ClampCoagulator Apparatus Having Improved Clamp Arm Pivot Mount,” filed Oct.10, 1997, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 6,325,811, entitled “Blades with Functional BalanceAsymmetries for use with Ultrasonic Surgical Instruments,” issued Dec.4, 2001, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 6,773,444, entitled “Blades with Functional BalanceAsymmetries for Use with Ultrasonic Surgical Instruments,” issued Aug.10, 2004, the disclosure of which is incorporated by reference herein;and U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool withUltrasound Cauterizing and Cutting Instrument,” issued Aug. 31, 2004,the disclosure of which is incorporated by reference herein.

Still further examples of ultrasonic surgical instruments are disclosedin U.S. Pub. No. 2006/0079874, entitled “Tissue Pad for Use with anUltrasonic Surgical Instrument,” published Apr. 13, 2006, the disclosureof which is incorporated by reference herein; U.S. Pub. No.2007/0191713, entitled “Ultrasonic Device for Cutting and Coagulating,”published Aug. 16, 2007, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2007/0282333, entitled “UltrasonicWaveguide and Blade,” published Dec. 6, 2007, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2008/0200940, entitled“Ultrasonic Device for Cutting and Coagulating,” published Aug. 21,2008, the disclosure of which is incorporated by reference herein; U.S.Pub. No. 2009/0105750, entitled “Ergonomic Surgical Instruments,”published Apr. 23, 2009, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2010/0069940, entitled “UltrasonicDevice for Fingertip Control,” published Mar. 18, 2010, the disclosureof which is incorporated by reference herein; and U.S. Pub. No.2011/0015660, entitled “Rotating Transducer Mount for UltrasonicSurgical Instruments,” published Jan. 20, 2011, the disclosure of whichis incorporated by reference herein; and U.S. Pub. No. 2012/0029546,entitled “Ultrasonic Surgical Instrument Blades,” published Feb. 2,2012, the disclosure of which is incorporated by reference herein.

Some of ultrasonic surgical instruments may include a cordlesstransducer such as that disclosed in U.S. Pub. No. 2012/0112687,entitled “Recharge System for Medical Devices,” published May 10, 2012,the disclosure of which is incorporated by reference herein; U.S. Pub.No. 2012/0116265, entitled “Surgical Instrument with Charging Devices,”published May 10, 2012, the disclosure of which is incorporated byreference herein; and/or U.S. Pat. App. No. 61/410,603, filed Nov. 5,2010, entitled “Energy-Based Surgical Instruments,” the disclosure ofwhich is incorporated by reference herein.

Additionally, examples of RF forceps are disclosed in U.S. Pat. No.6,860,882, entitled “Electro-Surgical Bipolar Forceps,” issued Mar. 1,2005, the disclosure of which is incorporated by reference herein.

While several surgical instruments and systems have been made and used,it is believed that no one prior to the inventors has made or used theinvention described in the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

While the specification concludes with claims which particularly pointout and distinctly claim this technology, it is believed this technologywill be better understood from the following description of certainexamples taken in conjunction with the accompanying drawings, in whichlike reference numerals identify the same elements and in which:

FIG. 1 depicts a perspective view of exemplary ultrasonic forceps;

FIG. 2 depicts a partially exploded view of the ultrasonic forceps ofFIG. 1;

FIG. 3A depicts a top plan view of the ultrasonic forceps of FIG. 1;

FIG. 3B depicts a top plan view of the ultrasonic forceps of FIG. 1,with a tine depressed;

FIG. 4 depicts a side elevational view of the ultrasonic forceps of FIG.1;

FIG. 5 depicts a side elevational view of the ultrasonic forceps of FIG.1, with the tines removed;

FIG. 6 depicts a detailed perspective view of a housing of theultrasonic forceps of FIG. 1, with an acoustic assembly removed;

FIG. 7 depicts an end view of the housing of FIG. 6;

FIG. 8 depicts a cross-sectional view of the housing of FIG. 6, with thecross section taken along line 8-8 of FIG. 6;

FIG. 9 depicts a perspective view of the housing of FIG. 6, with a tineremoved;

FIG. 10 depicts a perspective view of an ultrasonic transducer of theultrasonic forceps of FIG. 1;

FIG. 11 depicts an exploded view of the ultrasonic transducer of FIG.10;

FIG. 12 depicts a cross-sectional view of the ultrasonic transducer ofFIG. 10 inserted into the housing of FIG. 6, with the cross sectiontaken along line 12-12 of FIG. 10;

FIG. 13 depicts a perspective view of the waveguide assembly of theultrasonic forceps of FIG. 1;

FIG. 14 depicts a partially exploded view of the waveguide assembly ofFIG. 13;

FIG. 15 depicts a perspective view of an exemplary alternative tine thatmay be incorporated into the ultrasonic forceps of FIG. 1;

FIG. 16A depicts a cross-sectional view of the tine of FIG. 15, with thecross section taken along line 16-16 of FIG. 15;

FIG. 16B depicts a cross-sectional view of the tine of FIG. 15 in afirst bent state, with the cross section taken along line 16-16 of FIG.15;

FIG. 16C depicts a cross-sectional view of the tine of FIG. 15 in asecond bent state, with the cross section taken along line 16-16 of FIG.15;

FIG. 17 depicts a perspective view of an exemplary alternative housingthat may be incorporated into the ultrasonic forceps of FIG. 1;

FIG. 18 depicts a cross-sectional view of housing of FIG. 17, with thecross section taken along line 18-18 of FIG. 17;

FIG. 19 depicts a perspective view of the housing of FIG. 17, with aremovable tine inserted into the housing;

FIG. 20 depicts a partially exploded view of the housing and tine ofFIG. 19;

FIG. 21 depicts a cross sectional view of the housing of FIG. 19, withthe cross section taken along line 21-21 of FIG. 19;

FIG. 22 depicts a perspective view of an exemplary alternative padconfiguration that may be incorporated into the ultrasonic forceps ofFIG. 1;

FIG. 23 depicts an exploded view of the pad configuration of FIG. 22;

FIG. 24 depicts a cross-sectional view of the pad configuration of FIG.22, with cross-section taken along line 24-24 of FIG. 22;

FIG. 25 depicts a perspective view of an exemplary alternative padconfiguration that may be incorporated into the ultrasonic forceps ofFIG. 1;

FIG. 26 depicts a perspective view of an exemplary alternative tine thatmay be incorporated into the ultrasonic forceps of FIG. 1;

FIG. 27 depicts a perspective view of the tine of FIG. 26 in contactwith an active tine;

FIG. 28 depicts a perspective view of an exemplary alternative waveguideassembly that may be incorporated into the ultrasonic forceps of FIG. 1,having a slotted sheath;

FIG. 29 depicts a partially exploded view of an exemplary alternativewaveguide assembly that may be incorporated into the ultrasonic forcepsof FIG. 1, having a clam shell sheath;

FIG. 30 depicts a perspective view of the clam shell sheath of FIG. 29;

FIG. 31 depicts a perspective view of an exemplary alternativeultrasonic forceps;

FIG. 32 depicts a side elevational view of the ultrasonic forceps ofFIG. 31;

FIG. 33 depicts a top plan view of the ultrasonic forceps of FIG. 31;

FIG. 34 depicts a side elevational view of the ultrasonic forceps ofFIG. 31, with tines depressed;

FIG. 35 depicts a perspective view of an exemplary alternativeultrasonic forceps;

FIG. 36 depicts a side elevational view of the ultrasonic forceps ofFIG. 35;

FIG. 37 depicts a top plan view of the ultrasonic forceps of FIG. 35;

FIG. 38 depicts a side elevational view of an exemplary alterativeultrasonic forceps;

FIG. 39 depicts a top plan view of the ultrasonic forceps of FIG. 38;

FIG. 40 depicts a side elevational view of an exemplary alterativeultrasonic forceps;

FIG. 41 depicts a top plan view of the ultrasonic forceps of FIG. 40;

FIG. 42 depicts a perspective view of an exemplary alternativeultrasonic forceps having a two bend waveguide;

FIG. 43 depicts a top plan view of the ultrasonic forceps of FIG. 42;

FIG. 44 depicts a side elevational view of the ultrasonic forceps ofFIG. 42;

FIG. 45 depicts a side elevational view of the ultrasonic forceps ofFIG. 42, with tines removed;

FIG. 46 depicts a perspective view of an exemplary alternativeultrasonic forceps having a passive tine attached to a collar;

FIG. 47 depicts a perspective view of an exemplary alternativeultrasonic forceps;

FIG. 48A depicts a side elevational view of an exemplary alternativeultrasonic forceps having a symmetrical grip;

FIG. 48B depicts a partially exploded view of the ultrasonic forceps ofFIG. 48A;

FIG. 49 depicts a perspective view of an exemplary alternative set oftines including a rotatable passive tine;

FIG. 50A depicts an end view of the tines of FIG. 49, with a broad sideof a passive tine rotated toward an active tine;

FIG. 50B depicts an end view of the tines of FIG. 50A, with the tinesdepressed;

FIG. 50C depicts an end view of the tines of FIG. 49, with a cuttingside of the passive tine rotated toward the active tine;

FIG. 50D depicts an end view of the tines of FIG. 50C, with the tinesdepressed;

FIG. 51 depicts a perspective view of an exemplary alternative pad ofthe ultrasonic forceps of FIG. 1, having a cylindrical shape;

FIG. 52 depicts a perspective view of an exemplary alternative pad ofthe ultrasonic forceps of FIG. 1, having a hexagonal shape;

FIG. 53 depicts a perspective view of an exemplary alternative pad ofthe ultrasonic forceps of FIG. 1, having a triangular shape;

FIG. 54 depicts a perspective view of an exemplary alternative pad ofthe ultrasonic forceps of FIG. 1, having a plurality of graspingmembers; and

FIG. 55 depicts a perspective view of exemplary alternative tines havinga rotational active tine.

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the technology may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presenttechnology, and together with the description serve to explain theprinciples of the technology; it being understood, however, that thistechnology is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the technology shouldnot be used to limit its scope. Other examples, features, aspects,embodiments, and advantages of the technology will become apparent tothose skilled in the art from the following description, which is by wayof illustration, one of the best modes contemplated for carrying out thetechnology. As will be realized, the technology described herein iscapable of other different and obvious aspects, all without departingfrom the technology. Accordingly, the drawings and descriptions shouldbe regarded as illustrative in nature and not restrictive.

It is further understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Thefollowing-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

For clarity of disclosure, the terms “proximal” and “distal” are definedherein relative to a human or robotic operator of the surgicalinstrument. The term “proximal” refers the position of an element closerto the human or robotic operator of the surgical instrument and furtheraway from the surgical end effector of the surgical instrument. The term“distal” refers to the position of an element closer to the surgical endeffector of the surgical instrument and further away from the human orrobotic operator of the surgical instrument.

I. Exemplary Ultrasonic Forceps

FIGS. 1-14 illustrate an exemplary ultrasonic forceps (10). At least apart of forceps (10) may be constructed and operable in accordance withat least some of the teachings of U.S. Pat. No. 5,322,055; U.S. Pat. No.5,873,873; U.S. Pat. No. 5,980,510; U.S. Pat. No. 6,325,811; U.S. Pat.No. 6,773,444; U.S. Pat. No. 6,783,524; U.S. Pub. No. 2006/0079874; U.S.Pub. No. 2007/0191713; U.S. Pub. No. 2007/0282333; U.S. Pub. No.2008/0200940; U.S. Pub. No. 2009/0105750; U.S. Pub. No. 2010/0069940;U.S. Pub. No. 2011/0015660; U.S. Pub. No. 2012/0112687; U.S. Pub. No.2012/0116265; U.S. patent application Ser. No. 13/538,588; U.S. patentapplication Ser. No. 13/657,553; U.S. Pat. App. No. 61/410,603; and/orU.S. patent application Ser. No. 14/028,717. The disclosures of each ofthe foregoing patents, publications, and applications are incorporatedby reference herein. As described therein and as will be described ingreater detail below, forceps (10) is operable to cut tissue and seal orweld tissue (e.g., a blood vessel, etc.) substantially simultaneously.It should also be understood that forceps (10) may have variousstructural and functional similarities with the HARMONIC ACE® UltrasonicShears, the HARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS®Ultrasonic Shears, and/or the HARMONIC SYNERGY® Ultrasonic Blades.Furthermore, forceps (10) may have various structural and functionalsimilarities with the devices taught in any of the other references thatare cited and incorporated by reference herein.

To the extent that there is some degree of overlap between the teachingsof the references cited herein, the HARMONIC ACE® Ultrasonic Shears, theHARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears,and/or the HARMONIC SYNERGY® Ultrasonic Blades, and the followingteachings relating to forceps (10), there is no intent for any of thedescription herein to be presumed as admitted prior art. Severalteachings herein will in fact go beyond the scope of the teachings ofthe references cited herein and the HARMONIC ACE® Ultrasonic Shears, theHARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears,and the HARMONIC SYNERGY® Ultrasonic Blades.

FIG. 1 shows a perspective view of forceps (10) that is configured to beused in high precision surgical procedures (e.g., neurosurgery, spinalsurgery, plastic surgery, etc.). Forceps (10) comprises a housing (20),a pair of tines (42, 46), an acoustic assembly (60) and a cable (62). Ascan best be seen in FIG. 2, housing (20) connects tines (42, 46) andacoustic assembly (60) to forceps (10). In the present example, tines(42, 46) comprise a passive tine (42) and an active tine (46). The terms“active” and “passive” are meant to differentiate between tines (42, 46)on the basis of whether they are configured to provide some form ofenergy to tissue, as will be discussed in more detail below. Passivetine (42) extends distally from housing with a slight curve as itextends from its proximal end to its distal end. The distal end ofpassive tine (42) is configured with a foot (44). As will be describedin greater detail below, foot (44) has a geometry configured tocooperate with the end of a waveguide assembly (64) of acoustic assembly(60). Additionally, foot (44) may comprise a PTFE/Teflon tissuecontacting pad, as will be described in greater detail below. In someversions, a PTFE/Teflon tissue contacting pad is joined with foot (44)through a mating dovetail configuration. As another merely illustrativeexample, a PTFE/Teflon tissue contacting pad may be configured and/orjoined with foot (44) in accordance with at least some of the teachingsof U.S. Pub. No. 2006/0079874, the disclosure of which is incorporatedby reference herein. Other suitable ways in which a tissue contactingpad may be configured and/or joined with foot (44) will be apparent tothose of ordinary skill in the art in view of the teachings herein. Itshould also be understood that any of the other passive tines disclosedherein may include a tissue contacting pad.

Active tine (46) similarly extends distally from housing (20) having acurvature corresponding to that of passive tine (42). Unlike passivetine (42), active tine (46) is configured with a waveguide receiving end(48). Waveguide receiving end (48) is configured to receive a portion ofwaveguide assembly (64) of acoustic assembly (60), as will be describedin greater detail below. Each tine (42, 46) has an attachment member(50) on their respective proximal end configured to attach each tine(42, 46) to housing (20). Active and passive tines (42, 46) may attachto housing (20) by any suitable means such as screws, mechanicalfasteners, adhesives, or the like. In other examples methods ofattachment may be omitted entirely and each tine (42, 46) may be ofintegral construction with housing (20).

Each tine (42, 46) may be configured with a curvature to provide anergonomic grip for the user. It should be understood that in otherexamples, the curvature of each tine (42, 46) may be increased, reduced,or eliminated all together. Each tine (42, 46) is also shown as havinggripping portions (52) consisting of a plurality of transverse groovesin the surface of each tine (42, 46). Gripping portions (52) maylikewise be provided for an ergonomic grip for a user. Of course,gripping portions (52) may take on any suitable configuration, or may beomitted entirely. As also shown, housing (20) is located proximal togripping portions (52) in this example. This positioning of housing (20)may provide a desirable balancing of forceps (10) in the operator'shand. This positioning of housing (20) may also facilitate routing ofcable (62) away from the operator's hand, further enhancing theergonomics of forceps (10).

As shown in FIG. 2, acoustic assembly (60) comprises a transducer (80),waveguide assembly (64), an ultrasonic blade (66) and transducer housingmembers (68). Acoustic assembly (60) connects to cable (62) on itsproximal end. Cable (62) couples acoustic assembly (60) to a generator(not shown). The generator, may be configured to provide a power profileto acoustic assembly (60) that is particularly suited for the generationof ultrasonic vibrations through transducer (80), as will be describedin greater detail below.

Acoustic assembly (60) is secured in place relative to tines (42, 46) byhousing (20). Additionally, housing (20) houses a portion of transducer(80), preventing rotational and longitudinal movement of transducer (80)relative to housing (20). Waveguide assembly (60) extends distally fromtransducer (80). Ultrasonic blade (66) protrudes distally from waveguideassembly (60). As will be described in greater detail below, ultrasonicblade (66) is operable to cut through or seal tissue by means ofultrasonic energy communicated from transducer (80) through waveguideassembly (64) to ultrasonic blade (66). Transducer housing members (68)are configured to house the junction between cable (62) and acousticassembly (60), and the junction between transducer (80) to waveguideassembly (64).

FIGS. 3A-B show the relationship between acoustic assembly (60) andtines (42, 46). In particular, the curvatures of passive and activetines (42, 46) may provide an ergonomic grip for a user, while acousticassembly (60) extends along a relatively straight and central axisthrough a first dimension. As can be seen, active tine (46) does notcontact passive tine (42). Instead, waveguide assembly (64) extends fromwaveguide receiving end (48) of active tine (46) to a pointcorresponding in length to passive tine (42). Passive tine (42) isresiliently biased to a position offset from ultrasonic blade (66), ascan be seen in FIG. 3A. As shown in FIG. 3B, passive tine (42) may bedeformed by a user to be in close proximity with ultrasonic blade (66),or to incidentally contact ultrasonic blade (66). Accordingly, passivetine (42), active tine (46) and acoustic assembly (60) may becollectively used to grasp tissue of a patient between passive tine (42)and ultrasonic blade (66) of acoustic assembly (60).

FIGS. 4 and 5 show a side view of forceps (10), further illustrating therelationship between acoustic assembly (60) and tines (42, 46). As canbe seen, waveguide assembly (64) of acoustic assembly (60) has a bendalong a second dimension as it extends distally relative to housing(20). The bend of waveguide assembly (64) corresponds to a bend in tines(42, 46). Such a configuration may be suitable to provide a user withergonomic grip while limiting obstruction of view by forceps (10).Although a relatively gradual bend is shown in waveguide assembly (64),it should be understood that in other examples the bend may be more orless gradual, or may be omitted all together. Still in other examples,more than a single bend of waveguide assembly (64) may be incorporatedinto forceps (10). Other examples having different configurations ofbend angles or number of bends will be apparent to those of ordinaryskill in the art in view of the teachings herein.

A. Exemplary C-Clamp Housing

FIG. 6 shows a detailed perspective view of housing (20) with acousticassembly (60) removed. Housing (20) comprises an acoustic assemblyreceiving bore (22) and two clamping portions (24). As can be seen inFIG. 7, acoustic assembly receiving bore (22) has a circular shape whichcorresponds to transducer (80) of acoustic assembly (60). The interiorof acoustic assembly receiving bore (22) may be configured with anygeometry suitable to fixedly secure transducer (80) within acousticassembly receiving bore (22). For instance, acoustic assembly receivingbore (22) may comprise a series of grooves, recesses, or the likecorresponding to the exterior geometry of transducer (80). Such externalgeometry of transducer (80) will be described in greater detail below.

Each clamping portion (24) has a groove (26) configured to receiveattachment members (50) of each tine (42, 46). Grooves (26) generallycorrespond to attachment members (50) of each tine (42, 46). Each groove(26) defines two sidewalls (27). Sidewalls (27) ensure proper alignmentof tines (42, 46) relative to acoustic assembly (60). As describedabove, tines (42, 46) are configured to attach to housing (20) by meansof a screw fastening means. In other examples, different means offastening tines (42, 46) to housing (20) may be used. It should beunderstood that such a different fastening means may necessitate adifferent attachment member (50) geometry leading to a grooves (26) ofdifferent sizes, shapes, or configurations. Differing configurations ofattachment members (50) and grooves (26) will be apparent to those ofordinary skill in the art in view of the teachings herein.

FIG. 8 shows housing (20) in cross section. Clamping portion (24)defines a gap (25) that enables clamping portion (24) to be deformedoutwardly to receive transducer (80) in bore (22); then be brought backinwardly to clamp onto transducer (80). In the present example, oneclamping portion (24) is attached to the other with a screw (28) tomaintain a clamping force on transducer (80), thereby securing housing(20) to transducer (80). As can be seen, one clamping portion (24) maybe threaded such that screw (28) can engage that portion. Similarly,another clamping portion (24) may have a counter bore (29) to permitscrew (28) tighten beneath groove (26). Counter bore (29) may be oneither clamping portion (24), though the alignment procedure describedbelow may warrant positioning counter bore (29) on the clamping portion(24) that receives active tine (46). Screw (28) may be tightened to draweach clamping portion (24) closer to the other—closing gap (25) betweenclamping portions (24). Drawing the clamping portions (24) closer toeach other may accordingly permit the size of acoustic assemblyreceiving bore (22) to be reduced—clamping acoustic assembly (60) withinhousing (20) to prevent axial and rotational movement of acousticassembly (60). Acoustic assembly receiving bore (22) may include flats,annular shoulders, and/or etc. to further secure acoustic assembly (60)relative to housing (20). Screw (28) may also be loosened to permitclamping portions to move away from one another, enlarging gap (25). Gap(25) may permit acoustic assembly receiving bore (22) to expand to apoint where acoustic assembly (60) may be inserted into acousticassembly receiving bore (22) along an axial path. As can be seen in FIG.9, when acoustic assembly (60) is sufficiently tightened within housing(20), screw (28) may rest below the surface of groove (26) thuspermitting attachment of tines (42, 46).

Acoustic assembly receiving bore (22) may also comprise gaskets, seals,or the like to seal transducer (80) within housing. Seals or gaskets maybe comprised of any suitable material to seal transducer (80) and permitvarious suitable sterilization processes (e.g., steam, low temperaturehydrogen peroxide plasma, ethylene oxide, etc.). Of course, othervariations of clamping acoustic assembly (60) within housing (20) willbe apparent to those of ordinary skill in the art in view of theteachings herein.

To mount and align tines (42, 46) and acoustic assembly (60) in housing(20), passive tine (42) may first be mounted to housing (20). Acousticassembly (60) may then be inserted into the acoustic assembly receivingbore (22), aligning the axis of transducer (80) with the axis ofacoustic assembly receiving bore (22). Foot (44) of passive tine (42)may then be aligned with ultrasonic blade (66) by clamping foot (44) andultrasonic blade (66) together. Screw (28) may then be tightened toclamp acoustic assembly receiving bore (22) about acoustic assembly(60). As described above, counter bore (29) for screw (28) may be on theclamping portion (24) opposite of passive tine (42) because passive tine(42) may be secured to housing (20) before tightening of screw (28).Once screw (28) is tightened, active tine (46) may be inserted ontowaveguide assembly (64) and attached to housing (20). Other suitablealignment procedures will be apparent to those of ordinary skill in theart in view of the teachings herein.

B. Exemplary Ultrasonic Transducer

FIG. 10 shows a perspective view of transducer (80). As can be seen inFIG. 11, transducer (80) comprises an end mass (82), four piezoelectricdiscs (84), a horn (86) and a bolt (88). The components of transducer(80) are aligned along a longitudinal axis. Four piezoelectric discs(84) are sandwiched between end mass (82) and horn (86) with bolt (88)securing end mass (82) and horn (86) together. End mass (82) may act asa flange to secure piezoelectric discs (84) proximally relative totransducer (80). Flats (83) may be added to the surface of end mass (82)to provide a surface by which housing (20) may fixedly secure transducer(80). End mass (82) may be comprised of a metallic compounds such asstainless steel, carbon steel, or the like. Piezoelectric discs (84)comprise any suitable piezoelectric material which may allow thepiezoelectric discs (84) to expand or contract, in a rapidly vibratingfashion, in response to electric current such as lead zicronatetitanate, quartz, or the like.

Horn (86) comprises a flange portion (90) and a threaded stud (94).Flange portion (90) may act as a flange to secure the distal position ofpiezoelectric discs (84) relative to transducer (80). Flange portion(90) may be configured with geometric features to fixedly securetransducer (80) in housing. To reduce transverse displacement oftransducer (80) caused by vibrations, flange portion (90) is positionedat a nodal plane relative to piezoelectric discs (84). In other words,flange portion (90) is located at a longitudinal position correspondingto a node associated with ultrasonic vibrations generated bypiezoelectric discs (84). The longitudinal thickness of flange portion(90) may be limited by the wavelength of the ultrasonic vibrationsgenerated by piezoelectric discs (84). In the present example, flangeportion (90) has a longitudinal width of approximately 8% of theultrasonic wavelength generated by piezoelectric discs (84). Althoughsuch a width may vary between approximately 3 to 8% of the wavelengthgenerated by piezoelectric discs (84). It should be understood, that inother examples longitudinal width of flange portion may vary dependingon a variety of factors such as the ultrasonic vibrations utilized,transducer length and/or shape, waveguide length and/or shape, and thelike.

Horn (86) is configured to direct vibrations from piezoelectric discs(84) such that the vibrations may be communicated to waveguide assembly(64). Threaded stud (94) is configured to mechanically and acousticallycouple horn (86) with waveguide (78). In the present example, horn (86)is of a unitary design comprising a single material. Horn (86) may beconstructed of any material suitable to communicate vibrations frompiezoelectric discs (84) such as titanium, stainless steel, carbon steeltungsten or the like.

Bolt (88) is shown as using a threaded shaft and a collar to secure horn(86) to end mass (82). In other examples, bolt (88) may be omitted inlieu of another means of connecting end mass (82) and horn (86). Forinstance, horn (86) may be equipped with cylindrical member extendingproximally from the proximal end of horn (86). Such an extension maythen be welded to end mass. Still other examples for securing end mass(82) to horn (86) to compress piezoelectric discs (84) will be apparentto those of ordinary skill in the art in view of the teachings herein.

FIG. 12 shows transducer (80) attached to housing (20) in cross section.As can be seen, acoustic assembly receiving bore (22) may fixedly securetransducer (80) by engaging flange portion (90) of horn (86) and flats(83) of end mass (82). Horn (86) extends distally from housing (20)where it may connect to waveguide assembly (64) using a connectionsuitable to communicate vibrations to waveguide assembly (64). Inparticular, threaded stud (94) of horn (86) may engage a cooperativelythreaded recess (77) in waveguide (78).

As described above, transducer (80) may receive electrical power fromthe generator. In particular, transducer (80) may convert that powerinto ultrasonic vibrations through piezoelectric principals. By way ofexample only, the generator may comprise a GEN 300 or a GEN 11 sold byEthicon Endo-Surgery, Inc. of Cincinnati, Ohio. In addition or inalternative, the generator may be constructed in accordance with atleast some of the teachings of U.S. Pub. No. 2011/0087212, entitled“Surgical Generator for Ultrasonic and Electrosurgical Devices,”published Apr. 14, 2011, the disclosure of which is incorporated byreference herein.

Ultrasonic vibrations that are generated by transducer (80) may becommunicated to waveguide assembly (64) via horn (86). Waveguideassembly (64) may then communicate ultrasonic vibrations to ultrasonicblade (66). As noted above, when ultrasonic blade (66) is in anactivated state (i.e., vibrating ultrasonically), ultrasonic blade (66)is operable to effectively cut through and seal tissue, particularlywhen the tissue is being clamped between passive tine (42) andultrasonic blade (66).

C. Exemplary Ultrasonic Waveguide

FIG. 13 shows a perspective view of waveguide assembly (64). Waveguideassembly (64) comprises a three piece sheath (70) and a waveguide (78).Three piece sheath (70) comprises a straight proximal portion (72), abendable slotted portion (74), and a straight distal portion (76).Proximal and distal portions (72, 76) are configured to align coaxiallywith waveguide (78) along portions of waveguide (78) that arecorrespondingly straight. Proximal portion (72) may be inserted intotransducer housing member (68). By way of example only, proximal portion(72) is fixedly secured to transducer housing member (68) by a pin (96)inserted through holes in proximal portion (72) and transducer housingmember (68). Pin (96) is inserted transversely through waveguide (78) ata longitudinal position corresponding to a node associated withultrasonic vibrations communicated through waveguide (78). In otherexamples proximal portion (72) may be fixedly secured to transducerhousing member (68) by any suitable means such as snap fits, adhesivebonds, welding and/or etc.

Slotted portion (74) is configured to align coaxially with waveguide(78) along portions of waveguide (78) that are bent and/or curved.Transverse slots (75) cut into slotted portion (74) may permit slottedportion (74) to flex and/or bend to conform to the corresponding bendand/or curve of waveguide (78). The proximal and distal ends of slottedportion (74) may align with proximal portion (72) and distal portion(76), respectively, and be joined by any suitable joining method, suchthat proximal portion (72), slotted portion (74), and distal portion(76) form a unitary sheath around waveguide (78). Suitable means ofjoining proximal portion (72), slotted portion (74), and distal portion(76) may include laser welding, ultrasonic welding, adhesive bonding,and the like. Of course, a sheath surrounding waveguide (78) may takemany alternative configurations, as will be described in greater detailbelow.

Waveguide (78) comprises a generally cylindrical shaft extendingdistally from horn (86) of transducer (80). The distal end of waveguide(78) is shaped into ultrasonic blade (66). As shown in FIG. 14, aplurality of spacer rings (79) is disposed along the length of waveguide(78). Spacer rings (79) are added to maintain suitable spacing betweenwaveguide (78) and proximal portion (72), slotted portion (74), ordistal portion (76). Spacer rings (79) are located at longitudinalpositions corresponding to nodes associated with ultrasonic vibrationscommunicated through waveguide (78). Although five spacer rings (79) areshown, it should be understood that any suitable number of spacer rings(79), having any suitable spacing, may be used. Moreover, spacer rings(79) may be separate from waveguide (78) or integrally formed bywaveguide (78). Where spacer rings (79) are formed separately fromwaveguide (78), spacer rings (79) may comprise rubber o-rings. Othersuitable configurations of spacer rings (79) will be apparent to thoseof ordinary skill in the art in view of the teachings herein.

Waveguide (78) may require a precision bend and/or curve so thatultrasonic blade (66) may contact passive tine (42). Accordingly, insome instances, waveguide (78) may be bent or curved prior to installingproximal portion (72), slotted portion (74), and distal portion (76) onwaveguide (78). When such a bend or curve in waveguide (78) is used, thebend or curve may be located at a longitudinal position corresponding toan anti-node associated with ultrasonic vibrations communicated alongwaveguide (78), to thereby minimize transverse motion in waveguide (78).Once waveguide is bent or curved, slotted portion (74) may be firstinstalled on waveguide (78). Slotted portion (74) may then be bentand/or shaped to align with the bend or curve of waveguide (78).Subsequently, proximal portion (72) and distal portion (76) may beplaced on waveguide where they may be fixedly secured to slotted portion(74), as described above. Three piece sheath (70) may also include aseal (not shown) such as a heat shrink tubing placed over the slottedportion. Seal may prevent tissue, fluids, or other foreign materialsfrom entering the space between sheath (70) and waveguide (78), thusimproving the reusability of waveguide assembly (64). The proximal endof sheath (70) may be sealed by capturing the seal within transducerhousing member (68) Likewise, the distal end of sheath (70) may besealed using the distal most spacer ring (79). Of course, seal isentirely optional and may be omitted entirely. In other examples, aflexible thin-walled mechanical bellows (not shown) may be used in lieuof slotted portion (74), thus eliminating the need for seal. In such aconfiguration, proximal and distal portions (72, 76) may have a snug fitover or inside the ends of bellows to aid in sealing sheath (70).

As noted above, ultrasonic blade (66) is operable to cut through andseal tissue when ultrasonic blade (66) is in an activated state. Itshould be understood that waveguide (78) may be configured to amplifymechanical vibrations transmitted through waveguide (78) from transducer(80). Furthermore, waveguide (78) may include features operable tocontrol the gain of the longitudinal vibrations along the waveguide (78)and/or features to tune the waveguide (78) to resonant frequency of thesystem.

In the present example, the distal end of ultrasonic blade (66) islocated at a position corresponding to an anti-node associated withresonant ultrasonic vibrations communicated through waveguide (78), inorder to tune the acoustic assembly (60) to a preferred resonantfrequency f_(o) when the acoustic assembly is not loaded by tissue.Ultrasonic blade (66) may have an active length of approximately 7 mm,though the active length could be as long as approximately 9 mm. Whentransducer (80) is energized, the distal end of ultrasonic blade (66) isconfigured to move longitudinally in the range of, for example,approximately 10 to 500 microns peak-to-peak, and in some instances inthe range of about 20 to about 200 microns at a predetermined vibratoryfrequency f_(o) of, for example, 60 to 120 kHz. Other vibratoryfrequency f_(o) ranges could include, for example, 20 to 200 kHz, 60 to150 kHz, or 90 to 115 kHz. By way of example only, nominal frequenciesmay include 115 kHz, 90 kHz, or 80 kHz, depending on transducer (80)design, power applied thereto, and/or other variables. Additionally,transducer (80) may be driven at power levels ranging from 12 to 50watts with power levels being potentially dependent on variables such asdesired frequency, ultrasonic blade (66) design, transducer (80) design,and/or the like. When transducer (80) of the present example isactivated, these mechanical oscillations are transmitted throughwaveguide (78) to reach ultrasonic blade (66), thereby providingoscillation of ultrasonic blade (66) at the resonant ultrasonicfrequency. Thus, when tissue is secured between ultrasonic blade (66)and passive tine (42), the ultrasonic oscillation of ultrasonic blade(66) may simultaneously sever the tissue and denature the proteins inadjacent tissue cells, thereby providing a coagulative effect withrelatively little thermal spread. In some examples, as will be describedin greater detail below, an electrical current may also be providedthrough ultrasonic blade (66) and/or passive tine (42) to also seal thetissue using electrocautery.

II. Exemplary Alternative Features for Ultrasonic Forceps

In some instances it may be desirable to have alternative features offorceps (10). Variations of features utilized with forceps (10) maypermit forceps (10) to be used in a more robust array of surgicalprocedures or with a larger variety of surgical techniques. To theextent that any of the examples discussed below are shown and describedin the context of a variation of one particular feature of forceps (10),it should be understood that the same teachings may be readily appliedto the other variations of features utilized with forceps (10). Eachexample described below should therefore not be viewed as only havingapplicably to that particular feature of forceps (10). Furthermore, itis contemplated that the teachings below may be readily applied to otherkinds of forceps (10), not just variations of the features utilized withforceps (10).

A. Exemplary Alternative Tine Having Piezoelectric Material

FIG. 15 shows an exemplary alternative tine (140). Tine (140) may beused in addition to or in lieu of tines (42, 46) described above. Tine(140) may combine many of the same elements and features of tines (42,46) discussed above, with some modifications as will be described below.In the present example, tine (140) has a shape similar to passive tine(42), above. Similarly, tine (140) has an attachment member (150), and agripping portion (152). Although tine (140) is shown as having a foot(144) of similar shape to foot (44) discussed above, it should beunderstood that foot (144) may be configured with a geometry similar toultrasonic blade (66). In contrast to passive tine (42), tine (140) haspiezoelectric pads (142) affixed to tine (140). Piezoelectric pads (142)are shown as being oriented near gripping portion (152), though theycould be placed in any suitable position (e.g., at the distal end oftine (140)).

It should be understood that piezoelectric pads (142) may be integratedinto tine (140) to form a bimorph. Tine (140) is shown as having apiezoelectric pad (142) on two opposing surfaces of tine (140).Piezoelectric pads (142) may be coupled with a cable via wires, traces,and/or any other suitable kinds of electrical conduits. A generator maythereby provide electrical power to piezoelectric pads (142) toselectively activate piezoelectric pads (142). Because piezoelectricpads (142) deliver ultrasonic vibrations directly to tine (140), whichmay be held by a user, gripping portions (152) may be configured to bevibrationally isolated from piezoelectric pads. In some versions, atleast a portion of tine (140) may be constructed of a bimetallicmaterial (not shown) that may be used in lieu of piezoelectric pads(142). For instance, the bimetallic material may expand and contractthrough an application of an external stimulus such as localized heat orelectrical power.

Piezoelectric pads (142) may be operable to cooperatively induceultrasonic vibrations in tine (140). In particular, FIGS. 16A-16C showtine (140) in various stages of operation that may create ultrasonicvibrations in tine (140). In FIG. 16A, piezoelectric pads (142) have notbeen activated. Accordingly, the portion of tine (140) surrounded bypiezoelectric pads (142) has substantially zero transverse displacement.

In FIG. 16B, piezoelectric pads (142) are shown in an activated state.In particular, an electric current has been applied to eachpiezoelectric pad (142) with each pad (142) having a different polarityapplied thereto. Accordingly, one pad (142) may respond to the currentby expanding and the other by contracting. As can be seen, whenpiezoelectric pads (142) oppose one another by opposingly expanding orcontracting, piezoelectric pads (142) may cause the portion of tine(140) surrounded by piezoelectric pads (142) to have some transversedisplacement. This effectively may create a slight bend in tine (140).

FIG. 16C shows an operational condition substantially the same as thatshown in FIG. 16B, except an electric current of opposite polarity isapplied to piezoelectric pads (142). This may create a transversedisplacement or bend in tine (140) that is the inverse of that seen inFIG. 16B. Accordingly, piezoelectric pads (142) may be cycled throughthe operational states shown in FIGS. 16B and 16C rapidly to stimulateultrasonic vibrations in tine (140). It should be understood that otherconfigurations or operational states may similarly stimulate ultrasonicvibrations. For instance, piezoelectric pads (142) may be of differingshapes and/or sizes. In other examples, only one piezoelectric pad (142)may be active at a time. Other piezoelectric pad (142) configurations oroperational states will be apparent to those of ordinary skill in theart in view of the teachings herein.

B. Exemplary Alternative Housing and Removable Tine

FIGS. 17 through 21 shows an exemplary alternative housing (220).Housing is generally substantially the same as housing (20) shown abovewith certain exceptions described below. Housing (220) comprises anacoustic assembly receiving bore (222), two clamping portions (224), anda groove (226). These elements of housing (220) are substantially thesame as for housing (20) described above. In contrast to housing (20),housing (220) has a tine receiving channel (228) instead of a secondgroove (26).

Tine receiving channel (228) is configured to permit a tine (240) toquickly be removed from housing (220) without the need for additionaltools. As can be seen in FIGS. 17 through 21, tine receiving channel(228) comprises a resiliently biased locking member (230). Lockingmember (230) is resiliently biased to engage complementary geometry ofan attachment member (250) of a tine (240). As can best be seen in FIG.21, tine (240) may be inserted into tine receiving channel (228) where araised portion (254) of tine (240) may engage a corresponding indentedportion (232) in locking member (230). In other words, raised portion(254) may be received in indented portion (232) like a detent.Similarly, a user may remove tine (240) by applying force to adisengagement member (234) thus lifting indented portion (232) oflocking member (230) out of engagement with raised portion (254) of tine(240). Thus, when raised portion (254) is disposed in indented portion(232), tine (240) is selectively secured to housing (220).

The selective removability of tine (240) relative to housing (220)permits tine (240) to be a disposable part within an otherwise reusableforceps (10). For instance, the distal end of tine (240) may comprise aPTFE/Teflon pad that may wear out over time. When the PTFE/Teflon padwears out, tine (240) may be replaced instead of the entire forceps(10). Moreover, the selective removability of tine (240) may permit tine(240) to be part of a suite of tines (240) configured for differentsurgical procedures or techniques. Thus, an operator could use the sameforceps (10) with different tines (240) corresponding to differentsurgical procedures; and/or the operator could switch out tines (240)during a surgical procedure. It should be understood that in otherexamples tine receiving channel (228) may have various alternativeconfigurations and/or geometries that may be suitable to allow quickrelease of tine (240). Furthermore, tine receiving channel (228) may beconfigured for use with a tine (240) having the characteristics of anactive or passive tine, similar to those discussed above. Otherconfigurations and/or geometries will be apparent to those of ordinaryskill in the art in view of the teachings herein.

FIGS. 19 through 21 also depict housing (220) as comprising a connector(236). Connector is configured to permit an electrical power sourcecable (not shown) to attach to housing (220) such that the power sourcecable may communicate electrical power to tine (240) to enable tine(240) to deliver RF energy to tissue. Accordingly, forceps (10) may be acombination ultrasonic/RF forceps (10) when equipped with housing (220).A combination ultrasonic/RF forceps (10) may utilize ultrasonicoperational states separately from RF operational states depending onthe surgical procedure in which forceps (10) is being used. Forinstance, ultrasonic operational states may be used with ear, nose andthroat, or spinal surgical procedures. In contrast, RF operationalstates may be used in surgical procedures involving the brain. Anoperator may even selectively alternate between an ultrasonic mode andan RF mode within the same surgical procedure (e.g., based on thelocation of the anatomy and/or the state of the anatomy where forceps(10) are being used at that particular moment in the procedure). It isalso contemplated that tine (240) may be used in an ultrasonic mode andan RF mode simultaneously (or at least in a rapidly alternatingfashion). By way of example only, forceps (10) may be operable toalternate between ultrasonic activation of tine (240) and RF activationof tine (240), in an interlaced fashion, during a single transection oftissue. In other words, tine (240) may rapidly and automaticallyalternate between ultrasonic and RF power while tine (240) is in contactwith tissue. As yet another merely illustrative example, forceps (10)may provide a combination of ultrasonic and RF capabilities inaccordance with at least some of the teachings of U.S. patentapplication Ser. No. 14/086,085, entitled “Ultrasonic SurgicalInstrument with Electrosurgical Feature,” filed Nov. 21, 2013, thedisclosure of which is incorporated by reference herein.

To utilize RF operational states, housing (220) may fully or partiallycomprise an electrically insulative material (e.g., plastic, etc.) suchthat housing (220) is configured to electrically isolate tine (240) froman operator's hand and/or from other components of forceps (10). Foradditional insulative properties, a plastic or epoxy boot (not shown)may be overmolded onto attachment member (250) of tine (240).Additionally, to protect an operator when tine (240) is electricallyactivated, a substantial part of the region of tine (240) that is distalto attachment member (250) may be overmolded with a stiff plastic (e.g.,glass reinforced plastic) or rubber. Of course, the distal-most tip oftine (240) may be exposed from such an insulative material in order toenable the tip to apply electrical energy to tissue. RF signals may thenbe communicated from the electrical power source to tine (240)permitting tine to use RF energy to simultaneously cut and seal tissue.Although connector (236) is shown as being attached to housing (220), itshould be understood that connector (236) may be alternatively attachedto tine (240) and housing (220) may merely provide a space through whichconnector (236) may penetrate. In other words, connector (236) may be aunitary and integral feature of tine (240), extending proximally fromattachment member (250). Thus, when tine (240) is removed from housing(220) and a non-RF tine (42) is secured to housing (220), there may beno connector (236) extending proximally from connector (220).

In the present example housing (220) is shown as having a singleconnector (236). Thus, only a single tine (240) may be in communicationwith RF instrument (not shown) making forceps (10) a mono-polar forceps.In other examples, housing (220) may be configured with a secondconnector (not shown) for another tine (e.g., similar to tine (246)described above) making forceps (10) a bi-polar forceps. In such aconfiguration, the second connector may be internally connected to anelectrically conductive transducer (80), permitting RF energycommunication to ultrasonic blade (66). In such a configuration, tine(240) may form one pole and another tine (e.g., active tine (46)discussed above) may form another pole. It should also be understoodthat housing (220) and just a single connector (236) may be configuredto provide power to a transducer (80) and to provide bi-polar RF energy,such that two separate connectors (236) are not necessarily required inorder to provide bi-polar RF energy. For instance, connector (236) mayhave two separate electrical paths (e.g., coaxial, etc.). Connector(236) may be of any suitable shape and/or geometry sufficient tocommunicate electrical power for application of RF energy by forceps(10). Other suitable connector configurations, shapes, and/or geometrieswill be apparent to those of ordinary skill in the art in view of theteachings herein.

C. Exemplary Alternative Passive Tine Ends

To the extent that any of the examples discussed below are shown anddescribed in the context of a variation of tines (42, 46) of forceps(10), it should be understood that the same teachings may be readilyapplied to the other kind of tine (240). Thus, in addition to what iscontemplated below, a user may select among the various available tines(42, 46, 240) to couple a particular tine (42, 46, 240) to housing(220).

FIGS. 22 through 24 show an exemplary alternative passive tine (342).Passive tine (342) comprises similar features to that of passive tine(42) with certain exceptions noted below. In particular, passive tine(342) is shown as having a foot (344) shaped substantially the same asfoot (44) of passive tine (42). In contrast to passive tine (42),passive tine (342) is configured with a low friction sleeve (343). Ascan be seen in FIG. 23, isolating sleeve is cylindrical in shape havingan inner circumference smaller than the circumference of foot (44).Sleeve (343) may be comprised of a material having properties sufficientto permit sleeve (343) to stretch, and to provide low friction surfaceto passive tine (342) that may prevent tissue adhesion. During assembly,a stretching force may be applied to sleeve (343). While such a force isapplied to sleeve (343), foot (344) of passive tine (342) may beinserted into sleeve (343). Subsequently, when the stretching force isremoved, sleeve (343) may conform to the shape of foot (344).

Sleeve (343) may be comprised of any material suitable to provide a lowfriction surface and stretch around passive tine (342) such asPTFE/Teflon, rubber, or any other material having suitable properties.Additionally, if sleeve (343) is combined with an RF tine (e.g., similarto tine (240), above), the material of sleeve (343) may be suitable toconduct RF signals. For instance, a PTFE/Teflon sleeve (343) may beimpregnated with electromagnetically conductive particles such that RFsignals may flow therethrough. In other examples, PTFE/Teflon sleeve(343) may have plurality of openings filled with conductive gels orsimilar materials. In some other examples, sleeve (343) may comprise acarbon loaded PTFE/Teflon material or a high temperature PTC capable ofconducting electric current.

FIG. 24 depicts passive tine (342) and sleeve (343) in cross section. Ascan be seen, sleeve (343) extends proximally past foot (344). Inparticular, the proximal extension of sleeve (343) permits sleeve (343)to wrap behind the proximal end/edge of foot (344). This aspect ofsleeve (343) may provide sleeve (343) with additional longitudinalstability. It should be understood that such an extension is entirelyoptional, and may be omitted in other examples. Of course, otherconfigurations and/or materials of sleeve (343) will be apparent tothose of ordinary skill in the art in view of the teachings herein.

FIG. 25 depicts another exemplary alternative passive tine (442).Passive tine (442) is substantially the same as other passive tines (42,342) discussed above with certain exceptions noted below. In particular,passive tine (442) comprises a foot (444) which is substantially similarto the feet (44, 344) described above. However, foot (444) of passivetine (442) has an isolating pad (443) attached thereto. Isolating pad(443) has the same principal function as sleeve (343) discussed above—toprovide a low friction surface for passive tine (442) to resist tissueadhesion. As can be seen, however, isolating pad (443) is attached topassive tine (442) differently than sleeve (343). In particular,isolating pad (443) is fixedly secured to the bottom of foot (444).Isolating pad (443) may be fixedly secured to foot (444) by any suitablemeans such as adhesive bonding, ultrasonic welding, or the like.

FIGS. 26 and 27 show another exemplary alternative passive tine (542).Passive tine (542) is substantially the same as passive tines (42, 342,442) discussed above except passive tine (542) is equipped with atransversely extending distal leg (545). As can be seen in FIG. 27,distal leg (545) may overlap the distal end of ultrasonic blade (66)when passive tine (542) is actuated by a user as described above. Distalleg (545) may operate to retain tissue during a surgical procedure. Inother examples, passive tine (542) may be equipped with a variety ofdistal geometries corresponding to a particular surgical procedureand/or technique. Passive tine (542) may also include pads or sleeves(343, 443) as described above. Moreover, it should be understood that aplurality of passive tines (42, 342, 442, 542). May be used inconjunction with housing (220), described above, such that passive tines(42, 342, 442, 542) may be quickly swapped out for other passive tines(42, 342, 442, 542) in response to changes in surgical procedure ortechnique. Similarly, passive tine (42, 342, 442, 542) may be omittedentirely and active tine (46) may be used as a single cutter/dissector.Of course, other tines (42, 342, 442, 452) having differentconfigurations, materials, and/or uses will be apparent to those ofordinary skill in the art in view of the teachings herein.

D. Exemplary Alternative Waveguide Assemblies

FIG. 28 shows an exemplary alternative waveguide sheath (670) that maybe used in conjunction with waveguide (78) of waveguide assembly (64).Waveguide sheath (670) is a single unitary sheath having a plurality ofslots (671). Slots (671) are oriented along waveguide sheath (670) topermit waveguide sheath (670) to conform to the shape of waveguide (78).Sheath (670) may thus be particularly suited for versions of waveguide(78) that are curved (e.g., with a single curve, with a double curve ordogleg configuration, etc.). In particular, slots (671) may begin at theproximal end of sheath (670) and continue at to at least a point pastany bends and/or curves in the waveguide (78). In such a configuration,waveguide (78) may be first attached to transducer (80) and thenwaveguide sheath (670) may be introduced onto waveguide (78) from theproximal end of waveguide sheath (670). In the present example, slots(671) are arranged along the length of waveguide sheath (670) in groupsof slots (671) having consistent spacing. In such a configuration,spacing between slots (671) may increase at the longitudinal positionscorresponding to nodes associated with ultrasonic vibrationscommunicated along waveguide (78), to permit waveguide sheath (670) tocompletely cover spacer rings (79) or seals of waveguide (78). It shouldbe understood that this feature is merely optional and slots (671) mayhave variable or consistent spacing along waveguide sheath (670).

Although waveguide sheath (670) is shown as a substantially solid tubehaving slots (671) therein, it should be understood that in otherversions waveguide sheath (670) may use something other than a tube-slotdesign. For instance, waveguide sheath (670) may comprise a flat helicalspring extending the entire length of waveguide sheath (670). In such anexample, slots (671) may be formed by the spaces between each rotationof the flat helical spring. Yet in other examples, the tube of waveguidesheath (670) may be combined with a flat helical spring Like withwaveguide sheath (70) discussed above, waveguide sheath (670) may besealed to prevent fluid, tissue, or other substances from entering thespace between waveguide sheath (670) and waveguide (78). Of course, thisfeature is merely optional and may be omitted entirely. It should alsobe understood that waveguide sheath (670) may include an outer coveringsuch as a plastic cover, shrink wrap, and/or other kind of cover toprevent fluid and/or tissue from entering slots (671). Otherconfigurations of waveguide sheath (670) will be apparent to those ofordinary skill in the art in view of the teachings herein.

FIGS. 29 and 30 show another exemplary alternative waveguide sheath(770). Waveguide sheath (770) is substantially the same as waveguidesheath (670), discussed above, except that waveguide sheath (770) is asubstantially solid tube from proximal end to distal end. To accommodateany bend and/or curve in waveguide (78), waveguide sheath (770) isdivided in half longitudinally. Thus, each half of waveguide sheath(770) may be placed on waveguide (78) and then each half of waveguidesheath (770) may be fixedly secured to the other. Each half of waveguidesheath (770) may be fixedly secured to the other by any suitable meanssuch as ultrasonic welding, laser welding, adhesive bonding, or thelike. Other suitable configurations of waveguide sheaths (670, 770) willbe apparent to those of ordinary skill in the art.

III. Exemplary Alternative Ultrasonic Forceps Configurations

To the extent that any of the examples discussed below are shown anddescribed in the context of a variation of one particular kind offorceps (10, 810, 910, 1010, 1110, 1210, 1310, 1410, 1510), it should beunderstood that the same teachings may be readily applied to the otherkind of forceps (10, 810, 910, 1010, 1110, 1210, 1310, 1410, 1510). Eachexample described below should therefore not be viewed as only havingapplicability to either forceps (10), forceps (810), forceps (910),forceps (1010), forceps (1110), forceps (1210), forceps (1310), forceps(1410), or forceps (1510). Furthermore, it is contemplated that theteachings below may be readily applied to other kinds of surgicalinstruments, not just the variations of forceps (10, 810, 910, 1010,1110, 1210, 1310, 1410, 1510).

FIGS. 31 through 34 show an exemplary alternative ultrasonic forceps(810) having a substantially straight configuration. Forceps (810) issubstantially the same as forceps (10) having similar elements andfunctionality with certain expectations noted below. Forceps (810)comprises a housing (820), a pair of tines (842, 846) with graspingregions (852), an acoustic assembly (860) and a cable (862). Unlikehousing (20) of forceps (10), housing (820) is configured to fit betweentines (842, 846) rather than being offset. Similarly, tines (842, 846)and acoustic assembly (860) extend distally, along a straightlongitudinal axis, without having a curve or a bend in contrast to tines(42, 46) and acoustic assembly (60) of forceps (10).

As can best be seen in FIG. 32, housing (820) may attach to one tine(846) and act as a pivot point (823) for another tine (842). Unlikehousing (20) of forceps (10), housing (820) does not couple each tine(842, 846) together. Instead, the proximal end of each tine (842, 846)attaches to the other via an attachment region (845). Although tines(842, 846) are shown as being of integral construction, such that eachtine (842, 846) extends proximally from a single proximal end, it shouldbe understood that no such limitation is intended. Indeed, in otherexamples tines (842, 846) may be separate components, but yet have theirproximal ends secured to one another by any suitable means such aswelding, mechanical fastening, adhesive bonding, or the like.

Tines (840) may also be configured with a hole on the proximal end,through which cable (862) may be supported. Cable (862) may then be usedto couple acoustic assembly (860) to the generator. The generator mayhave similar functionality and operational characteristics as thegenerator described above.

Like tine (42), tine (842) may be resiliently biased to maintain a gapbetween a foot (844) and an ultrasonic blade (866), but is bendable todrive foot (844) with a tissue pad toward ultrasonic blade (866). Tomaintain alignment of tines (842, 846) relative to acoustic assembly(860) along a consistent closure plane as foot (844) travels towardultrasonic blade (866), tine (846) of the present example comprises aguide post (841). Tine (842) includes an opening (843) configured toreceive guide post (841). Thus, as tine (842) is deformed and movedtoward acoustic assembly (860), guide post (841) and opening (843) workcooperatively to maintain alignment of tines (842, 846) with acousticassembly (860) along a consistent closure plane. Post (841) and opening(843) thus ensure alignment of foot (844) and ultrasonic blade (866)along the pivot/closure plane. Other configurations of forceps (810)incorporating elements of the various examples described above will beapparent to those of ordinary skill in the art in view of the teachingsherein.

FIGS. 35 through 37 show another exemplary alternative ultrasonicforceps (910). Forceps (910) is substantially the same as forceps (10,810) having similar elements and functionality with certain exceptionsnoted below. Forceps (910) comprises a housing (920), a pair of tines(942, 946) with grasping regions (952), an acoustic assembly (960) and acable (962). Like tine (42), tine (942) is resiliently biased tomaintain a gap between a foot (944) and an ultrasonic blade (966), butis bendable to drive foot (944) with a tissue pad toward ultrasonicblade (966). Forceps (910) combines elements of forceps (10) and forceps(810) to create a hybrid between the two. For instance, as in forceps(10), housing (920) attaches to, and is offset from, both tines (942,946). However, housing (920) in this configuration may act as a forceregulating member for tines (942, 946), rather than merely providingalignment and support for tines (942, 946). For instance, the positionof housing (920) along the length of tine (942) may restrict the forcewith which foot (944) may compress tissue against blade (966), byeffectively defining the bending length of tine (942). Positioninghousing (920) further distally along tine (942) may decrease the forcewith which foot (944) may compress tissue against blade (966); whilepositioning housing (920) further proximally along tine (942) mayincrease the force with which foot (944) may compress tissue againstblade (966).

Additionally, as in forceps (10), tines (942, 946) and acoustic assembly(960) are bent or curved for ergonomic grip and to maximize surgicalsite visibility. On the other hand, like forceps (810), the proximal endof each tine (942, 946) integrally connects to the other. The proximalend of each tine (942, 946), however, curves relative to the other tointegrally connect. Tines (942, 946) thus together form a unitarystructure in this example. Other examples of forceps (910) incorporatingelements of the various examples described above will be apparent tothose of ordinary skill in the art in view of the teachings herein.

FIGS. 38 and 39 show another exemplary alternative ultrasonic forceps(1010). Similar to forceps (810, 910) discussed above, forceps (1010)has similar elements and functionally as seen above with forceps (10).In particular, forceps (1010) comprises housing (1020), a pair of tines(1042, 1046) with grasping regions (1052), an acoustic assembly (1060),and a cable (1062). Unlike housing (20, 820, 920), housing (1020) isintegrated into forceps (1042, 1046). Similarly, acoustic assembly(1060) is integrated into one tine (1046), and includes a waveguide thatis curved, following the curved path of tine (1046). Accordingly, onetine (1046) may act as a pivot for the other tine (1042), thus allowinghousing (1020) and acoustic assembly (1060) to pivot, moving a foot(1044) with a tissue pad toward an ultrasonic blade (1066). Of course,other examples of forceps (1010) incorporating elements of the variousexamples described above will be apparent to those of ordinary skill inthe art in view of the teachings herein.

FIGS. 40 and 41 show another exemplary alternative ultrasonic forceps(1110). Forceps (1010) is substantially the same as forceps (10, 810,910, 1010) having similar elements and functionality with certainexceptions noted below. Forceps (1110) comprises a housing (1120), apair of tines (1142, 1146) with grasping regions (1152), an acousticassembly (1160) and a cable (1162). Forceps (1110) is similar to forceps(910) in that it combines elements of forceps (10) and forceps (810) tocreate a hybrid between the two. For instance, like forceps (10),housing (1120) is offset from both tines (1142, 1146). Additionally,like forceps (10), tines (1142, 1146) are bent or curved for ergonomicgrip and to maximize surgical site visibility. On the other hand, likeforceps (810), only a single tine (1142, 1146) is attached to housing.Similarly, acoustic assembly (1160) extends distally without having abend or curve. Also like forceps (810), the proximal end of each tine(1142, 1146) integrally connects to the other. The proximal end of eachtine (1142, 1146), however, curves relative to the other to integrallyconnect. Tines (1142, 1146) thus together form a unitary structure inthis example.

Housing (1120) is also positioned such that it does not restrict themovement of tine (1142) as tine (1142) pivots from its resilientlybiased position urging a foot (1144) toward an ultrasonic blade (1160).Similar to tines (842, 846), tines (1142, 1146) are equipped with aguide post (1141) and an opening (1143) configured to receive guide post(1141). As noted above with forceps (810), this feature maintainslongitudinal alignment of tines (1142, 1146) relative to acousticassembly (1160) as tines (1142, 1146) transition between an openconfiguration and a closed configuration. Other examples of forceps(1110) incorporating elements of the various examples described abovewill be apparent to those of ordinary skill in the art in view of theteachings herein.

FIGS. 42-45 show another exemplary alternative ultrasonic forceps(1210). Forceps (1210) is substantially the same as forceps (10, 810,910, 1010, 1110) having similar elements and functionality with certainexpectations noted below. Forceps (1210) comprises a housing (1220), apair of tines (1242, 1246) with grasping regions (1252), an acousticassembly (1260) and a cable (1262). Housing (1220) is offset from tines(1242, 1246) which wrap around housing (1220) and may be fixedly securedthereto. Like tine (42), tine (1242) is resiliently biased to maintain agap between a foot (1244) and an ultrasonic blade (1266), but isbendable to drive foot (1244) with a tissue pad toward ultrasonic blade(1266). Similar to tines (42, 46) and acoustic assembly (60) of forceps(10), tines (1242, 1246) and acoustic assembly (1260) are bent orcurved. However, unlike tines (42, 46) and acoustic assembly (60), tines(1242, 1246) and acoustic assembly (1260) have two bends or curves.Additionally, instead of each tine (1242, 1246) being separately securedto housing, each tine (1242, 1246) curves around housing (1220) andintegrally connects to the other. Of course, other configurations offorceps (1210) incorporating elements of the various examples describedabove will be apparent to those of ordinary skill in the art in view ofthe teachings herein. It should also be understood that a waveguidesheath is omitted from FIGS. 42-45 for clarity. Some versions of forceps(1210) may include a sheath about the waveguide of acoustic assembly(1260) (e.g., to provide protection to the waveguide and/or acousticisolation relative to the operator's hand, etc.).

FIG. 46 shows another exemplary alternative ultrasonic forceps (1310).Forceps (1310) is substantially the same as forceps (10, 810, 910, 1010,1110, 1210) having similar elements and functionality with certainexpectations noted below. Forceps (1310) comprises a housing (1320), atine (1342), an acoustic assembly (1360) and a cable (not shown). Tine(1342) includes a gripping feature (1352). Like tine (42), tine (1342)is resiliently biased to maintain a gap between a pad (1343) and a blade(1366), but is bendable to drive pad (1343) toward blade (1366). Unlikeforceps (10, 810, 910, 1010, 1110, 1210) discussed above, forceps (1310)has a single tine (1342) while acoustic assembly (1360) acts as a secondtine (1346). Acoustic assembly (1360) extends distally without having acurve and/or bend. Moreover, housing (1320) does not connect tine (1342)to acoustic assembly (1360). Instead, acoustic assembly (1360) includesa collar (1361), which provides a structure for securing tine (1342) toacoustic assembly (1360). Tine (1340) may be fixedly secured to collar(1361) by any suitable means such as welding, adhesive bonding,mechanical fastening or the like.

In some versions, blade (1366) has a non-circular cross-sectionalprofile. In addition or in the alternative, blade (1366) may have across-sectional profile that is asymmetric. In either kind of versions,collar (1361) may be rotatable about the longitudinal axis of acousticassembly (1360), thereby providing orbital movement of tine (1342) andpad (1343) about the longitudinal axis of acoustic assembly (1360). Suchselective orbital positioning may enable a pad (1343) to be driventoward different geometrical features of a blade (1366) (e.g., toward aflat surface of blade, toward a sharp edge of blade, etc.). Thus, collar(1361) may be rotated to provide different orbital orientations of pad(1343) relative to blade (1366), corresponding to different modes ofoperation (e.g., sharp edge for mechanical cutting, flat surface forultrasonic cutting or tissue sealing, etc.). Other configurations offorceps (1310) incorporating elements of the various examples describedabove will be apparent to those of ordinary skill in the art in view ofthe teachings herein.

FIG. 47 shows another exemplary alternative ultrasonic forceps (1410).Forceps (1410) is substantially the same as forceps (10, 810, 910, 1010,1110, 1210, 1310) having similar elements and functionality with certainexpectations noted below. Forceps (1410) comprises a housing (1420), atine (1442, 1446), an acoustic assembly (1460) and a cable (1462) Likewith forceps (1310), forceps (1410) has a single tine (1442) withacoustic assembly (1460) acting as an active tine (1446). Tine (1442)includes a gripping feature (1452). Both tine (1442, 1446) and acousticassembly (1460) are fixedly secured to housing (1420) and extenddistally therefrom. Tine (1442) is resiliently biased to maintain a gapbetween a foot (1444) and an ultrasonic blade (1466), but is bendable todrive foot (1444) with a tissue pad toward ultrasonic blade (1466). Atransducer (not shown) may be integrated into housing (1420) to provideultrasonic vibrations to acoustic assembly (1460). Of course, otherexamples of forceps (1410) incorporating elements of the variousexamples described above will be apparent to those of ordinary skill inthe art in view of the teachings herein.

FIGS. 48A and 48B show another exemplary alternative ultrasonic forceps(1510). Forceps (1510) is substantially the same as forceps (10, 810,910, 1010, 1110, 1210, 1310, 1410) having similar elements andfunctionality with certain expectations noted below. Forceps (1510)comprises a housing (1520), a pair of tines (1542, 1546) with graspingregions (1552), an acoustic assembly (1560) and a cable (1562) Like withhousing (1420) of forceps (1410), housing (1510) has tines (1542, 1546)and acoustic assembly (1560) fixedly secured thereto and extendingdistally therefrom. Also like housing (1420), housing (1520) has atransducer (1580) integrated therein. However, unlike forceps (1410),forceps (1510) comprise two tines (1542, 1546). Tine (1542) isresiliently biased to maintain a gap between a foot (1544) and anultrasonic blade (1566), but is bendable to drive foot (1544) with atissue pad toward ultrasonic blade (1566). Another tine (1546) isconfigured to arc toward and meet with ultrasonic blade (1566) at a nodeor acoustically isolated feature, such that tine (1546) and the acousticassembly form an integrated unit. As can best be seen in FIG. 48B, onetine (1542) may be configured to be selectively removed from housing(1520). Forceps (1510) additionally comprises a button (1521) which maybe used to selectively switch between operational states describedabove. Of course, other examples of forceps (1510) incorporatingelements of the various examples described above will be apparent tothose of ordinary skill in the art in view of the teachings herein.

FIGS. 49 through 54 show an exemplary alternative set of tines (1640).Tines (1640) are substantially the same as tines (42, 46) having similarelements and functionality with certain exceptions noted below. Tines(1640) are shown as having a passive tine (1642) and an active tine(1646). Unlike passive tine (42), the distal end (1643) of passive tine(1642) is configured to selectively rotate about the longitudinal axisof passive tine (1642) such that differing tissue pads (1645, 1645) mayface active tine (1646). In particular, distal end (1643) of passivetine (42) includes a substantially flat tissue pad (1645) and asubstantially triangular tissue pad (1647) in this example. Triangulartissue pad (1647) includes a relatively narrow contact flat (1650). Flattissue pad (1645) has a cross-sectional height that is greater than thediameter of ultrasonic blade (1649); while contact flat (1650) has across-sectional height that is less than the diameter of ultrasonicblade (1649). In some versions, the cross-sectional height of contactflat (1650) is approximately ½ the diameter of ultrasonic blade (1649).

In FIGS. 50A-50B, distal end (1643) of passive tine (1646) is orientedsuch that flat tissue pad (1645) faces the ultrasonic blade (1649) ofactive tine (1646). In FIG. 50A, passive tine (1642) is spaced fromactive tine (1646) such that tissue may be received in a gap betweenflat tissue pad (1645) and ultrasonic blade (1649) of active tine(1646). In FIG. 50B, passive tine (1642) is driven toward active tine(1646), which would result in compression of tissue between flat tissuepad (1645) and ultrasonic blade (1649) of active tine (1646). In someinstances, this may provide sealing of the tissue and/or relatively slowcutting of the tissue. In FIGS. 50C-50D, distal end (1643) of passivetine (1646) is oriented such that triangular tissue pad (1647) facesultrasonic blade (1649) of active tine (1646). In FIG. 50C, passive tine(1642) is spaced from active tine (1646) such that tissue may bereceived in a gap between triangular tissue pad (1647) and ultrasonicblade (1649) of active tine (1646). In FIG. 50D, passive tine (1642) isdriven toward active tine (1646), which would result in compression oftissue between triangular tissue pad (1647) and ultrasonic blade (1649)of active tine (1646). In some instances, this may provide relativelyfast cutting of the tissue. The smaller surface area of contact flat(1650), as compared to the surface area of flat tissue pad (1645), mayprovide higher compression of tissue than flat tissue pad (1645). Itshould also be understood that triangular tissue pad (1647) may providemechanical cutting of tissue without ultrasonic blade (1649) of activetine (1646) being ultrasonically activated.

FIGS. 51 through 54 show varying alternative exemplary end geometries(1743, 1843, 1943, 2043) which may be used in addition to and/or in lieuof the geometries of tissue pads (1645, 1647) described above. Inparticular, FIG. 51 shows an end geometry (1743) having a circularcross-sectional profile. FIG. 52 shows an end geometry (1843) having anoctagonal cross-sectional profile. FIG. 53 shows an end geometry (1943)having a triangular cross-sectional profile. FIG. 54 shows an endgeometry (2043) having a series of flats separated by a series ofridges. It should be understood that any of these end geometries (1743,1843, 1943, 2043) may be incorporated into one or more tissue pads atthe distal end of passive tine (1642). It should also be understood thatend geometries (1743, 1843, 1943, 2043) need not necessarily be providedon passive tine (1642). Indeed, active tine (1646) may also be equippedwith any of the end geometries (1645, 1647, 1843, 1943, 2043) describedabove. It should also be understood that the end geometry of a passivetine (1642) may vary along the length of passive tine (1642), such thatone tissue contacting area of passive tine (1642) may have one geometry,while another tissue contacting area of passive tine (1642) may haveanother geometry. Various suitable configurations and permutations willbe apparent to those of ordinary skill in the art in view of theteachings herein.

FIG. 55 shows exemplary alternative tines (2140) having an active tine(2146) with a distal end (2143) that is rotatable about the longitudinalaxis of active tine (2146). This rotatability may provide selectivevariability in the geometries that are exposed to a tissue pad (2141) ofpassive tine (2142). In other words, an operator may select a particulargeometric configuration to engage tissue between distal end (2143) andtissue pad (2141). It should be understood that active tine (2146) mayalso incorporate any of the alternative end geometries (1643, 1743,1843, 1943, 2043) discussed above. Other configurations of tines (1640,2140) incorporating elements of the various examples described abovewill be apparent to those of ordinary skill in the art in view of theteachings herein.

In some instances, an instrument provides a combination of features offorceps (1310) with features of tine (1642) and/or features of tine(2146). For instance, one exemplary instrument may provide an orbitalmotion of a passive tine about the longitudinal axis of blade (1366), incombination with rotatability of the distal end (1643) of a passive tine(1642) about the longitudinal axis of passive tine (1642). This mayprovide even further variations in the combinations of geometriesbetween which tissue may be compressed, particularly when both blade(1366) and distal end (1643) each have asymmetric cross-sectionalprofiles. As another merely illustrative example, an instrument mayprovide an orbital motion of a passive tine about the longitudinal axisof blade (1366), in combination with rotatability of the distal end(2143) of an active tine (2146) about the longitudinal axis of activetine (2146). As yet another merely illustrative example, an instrumentmay provide a combination of rotatability of the distal end (1643) of apassive tine (1642) about the longitudinal axis of passive tine (1642)with rotatability of the distal end (2143) of an active tine (2146)about the longitudinal axis of active tine (2146). Other suitablecombinations will be apparent to those of ordinary skill in the art inview of the teachings herein.

IV. Miscellaneous

It should be understood that any of the versions of instrumentsdescribed herein may include various other features in addition to or inlieu of those described above. By way of example only, any of theinstruments described herein may also include one or more of the variousfeatures disclosed in any of the various references that areincorporated by reference herein. It should also be understood that theteachings herein may be readily applied to any of the instrumentsdescribed in any of the other references cited herein, such that theteachings herein may be readily combined with the teachings of any ofthe references cited herein in numerous ways. Other types of instrumentsinto which the teachings herein may be incorporated will be apparent tothose of ordinary skill in the art.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

Versions of the devices described above may have application inconventional medical treatments and procedures conducted by a medicalprofessional, as well as application in robotic-assisted medicaltreatments and procedures. By way of example only, various teachingsherein may be readily incorporated into a robotic surgical system suchas the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif.Similarly, those of ordinary skill in the art will recognize thatvarious teachings herein may be readily combined with various teachingsof U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool withUltrasound Cauterizing and Cutting Instrument,” published Aug. 31, 2004,the disclosure of which is incorporated by reference herein.

Versions described above may be designed to be disposed of after asingle use, or they can be designed to be used multiple times. Versionsmay, in either or both cases, be reconditioned for reuse after at leastone use. Reconditioning may include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, someversions of the device may be disassembled, and any number of theparticular pieces or parts of the device may be selectively replaced orremoved in any combination. Upon cleaning and/or replacement ofparticular parts, some versions of the device may be reassembled forsubsequent use either at a reconditioning facility, or by a userimmediately prior to a procedure. Those skilled in the art willappreciate that reconditioning of a device may utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometrics, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

I/We claim:
 1. A surgical instrument comprising: (a) a housing; (b) anacoustic assembly supported by the housing, the acoustic assemblycomprising: (i) a transducer, wherein the transducer is configured togenerate ultrasonic vibrations, (ii) a waveguide extending from thetransducer, wherein the waveguide is acoustically coupled to thetransducer, and (iii) an ultrasonic blade extending from a distal end ofthe waveguide; and (c) a first tine, wherein the first tine comprises agripping feature, wherein the first tine is secured relative to thehousing, wherein the first tine is configured to move relative to thewaveguide, wherein a distal end of the first tine is configured to movetoward the ultrasonic blade in response to movement of the first tinerelative to the waveguide, wherein the transducer is located proximal tothe gripping feature.
 2. The surgical instrument of claim 1, furthercomprising a second tine, wherein the second tine is secured relative tothe housing, wherein the second tine extends distally from the housing.3. The surgical instrument of claim 2, wherein the second tine comprisesa distal end, wherein the distal end is configured to receive thewaveguide.
 4. The surgical instrument of claim 1, wherein the waveguidehas at least one bent portion.
 5. The surgical instrument of claim 4,wherein the acoustic assembly further comprises a waveguide sheath,wherein the waveguide is configured to slide into the waveguide sheathand accommodate the at least one bent portion.
 6. The surgicalinstrument of claim 1, wherein the distal end of the first tinecomprises a cylindrical sheath, wherein the sheath is configured tostretch around the distal end of the first tine.
 7. The surgicalinstrument of claim 1, wherein the housing comprises a tine receivingchannel, wherein the tine receiving channel is configured to receive aproximal end of the first tine.
 8. The surgical instrument of claim 7,wherein the tine receiving channel comprises a resiliently biasedlocking member, wherein the resiliently biased locking member isconfigured to selectively secure the first tine in the tine receivingchannel of the housing.
 9. The surgical instrument of claim 1, whereinthe transducer comprises a horn configured to direct ultrasonicvibrations to the waveguide.
 10. The surgical instrument of claim 9,wherein the horn of the transducer comprises a flange portion, whereinthe housing is configured to secure the flange portion.
 11. The surgicalinstrument of claim 10, wherein the flange portion of the horn comprisesa plurality of flats, wherein the housing comprises a plurality of flatscorresponding to the plurality of flats of the flange portion.
 12. Thesurgical instrument of claim 11, wherein the flange portion of the hornhas a longitudinal thickness that is approximately 3% to approximately8% of a wavelength of ultrasonic vibrations generated by the transducer.13. The surgical instrument of claim 1, further comprising a radiofrequency connector, wherein the radio frequency connector is incommunication with the first tine, wherein the radio frequency connectoris configured to communicate radio frequency energy to the first tine.14. The surgical instrument of claim 13, wherein the radio frequencyconnector is integral with the first tine such that the radio frequencyconnector and the first tine are together removable as a unit from thehousing.
 15. The surgical instrument of claim 1, wherein the first tinedefines a longitudinal axis, wherein the first tine further includes afirst portion and a second portion, wherein the second portion isrotatable relative to the first portion about the longitudinal axis. 16.The surgical instrument of claim 1, wherein the ultrasonic blade definesa longitudinal axis, wherein the first tine is orbital about thelongitudinal axis of the ultrasonic blade.
 17. A surgical instrumentcomprising: (a) a housing having a first tine receiving channel and atransducer receiving portion; (b) a transducer, the transducercomprising: (i) at least one piezoelectric element operable to generateultrasonic vibrations, and (ii) a flange portion, wherein the flangeportion is fixedly secured to the transducer receiving portion of thehousing; (c) a waveguide having a proximal end and a distal end, whereinthe waveguide is configured to communicate ultrasonic vibrations fromthe proximal end to the distal end, wherein the waveguide is incommunication with the transducer; (d) an ultrasonic blade, wherein theultrasonic blade is in communication with a distal end of the waveguide,wherein the ultrasonic blade is configured to vibrate in response toultrasonic vibrations communicated through the waveguide from thepiezoelectric discs; and (e) a first tine, wherein a portion of thefirst tine is secured to the tine receiving channel of the housing,wherein the first tine extends distally from the housing, wherein thefirst tine is configured to move relative to the housing toward theultrasonic blade.
 18. A surgical instrument of claim 17, wherein theflange portion comprises a plurality of flats, wherein the transducerreceiving portion of the housing is configured to contact the flats torestrict rotational movement of the transducer.
 19. A surgicalinstrument of claim 17, wherein the waveguide comprises a first bend anda second bend, wherein the first bend is positioned at an anti-noderegion of the waveguide, wherein the second bend is positioned atanother anti-node region of the waveguide.
 20. A surgical instrumentcomprising: (a) a housing; (b) an acoustic assembly secured relative tothe housing, wherein the acoustic assembly is configured to generateultrasonic vibrations; (c) an ultrasonic blade, wherein the ultrasonicblade is in communication with the acoustic assembly; and (d) a firsttine, wherein the first tine is rotatably secured relative to theacoustic assembly such that the first tine is configured to selectivelyorbit about a longitudinal axis of the acoustic assembly, wherein thefirst tine is further configured to move relative to the acousticassembly to urge the first tine toward the ultrasonic blade.